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Building a portfolio of research                           findingsfor use by healthcare managers and decision-makers usin...
Who are we – what do we do?    National Institute for                                To have an       Health Research     ...
What do we mean by need?  Ability to benefit – mediated through service organisation and delivery                         ...
Identifying need (the right research questions)Engaging with the research-using community; meeting its needsCollect sugges...
What do we mean by integration?                                  5
Integrated care portfolio: April 2009 – Sept 2011Specific calls for research relevant to integrated care Call title       ...
Completed research                         In progress‘Self care and case management in           ‘Assessing outcomes of i...
Mensajes para llevar a casa(take home messages)•    NIHR Health Service and Delivery Programme is focussed on evidence for...
ADDITIONAL SLIDES                    9
Example completed Research‘Self care and case management in        ‘Self management support amonglong term conditions’,   ...
Example research under way‘Analysis of virtual wards’,           ‘Assessing outcomes of integrated care                   ...
What do we mean by impact?                     Outputs                       (e.g.                                Outcomes...
Our theory of changeEnvironment level: The research pathway                                                               ...
Our ‘needs-led approach’Needs-led, science-added evidence production                                                    = ...
The NIHR Health Research System                                    Faculty                  Investigators &               ...
NETS (Evaluation, Trials and Studies programmes)                                                     Systematic Reviews   ...
Research funding contextNational Institute for Health Research•£1bn (€1.2bn)/year applied health research system•UK Depart...
Who are we – what do we do?                                                                 What      National Institute f...
Self-care and Case Managementin Long-term ConditionsProfessor David Challis, University of Manchester                     ...
Self Management Support amongOlder AdultsMs Suzanne Parsons, Picker Institute Europe To                To compare investig...
Analysis of Virtual WardsDr Geraint Lewis, Nuffield Trust                                                   To develop To ...
Assessing outcomes of integratedcare for people with long termconditionsProfessor Gillian Parker, University of York      ...
Identifying the right research questionsEngaging with the research-using community; meeting its needsAnnual stakeholder en...
What happens in practice: work streams                              Types of           Who defines      Frequency         ...
Two stage assessment process •   Health need •   Expressed need •   Sustained interest •   Capacity to generate new knowle...
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Building a portfolio of research findings for use by healthcare managers and decisio-makers using integrated care as a sample theme

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Building a portfolio of research findings for use by healthcare managers and decision-makers using integrated care as a sample theme

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Building a portfolio of research findings for use by healthcare managers and decisio-makers using integrated care as a sample theme

  1. 1. Building a portfolio of research findingsfor use by healthcare managers and decision-makers usingintegrated care as a sample themeNIHR Health Services and Delivery Research programmeMatt Westmore, Director of NETSCCSteph Garfield-Birkbeck, Assistant DirectorDonna White, Research Fellow
  2. 2. Who are we – what do we do? National Institute for To have an  Health Research IMPACT What research do managers £1bn (€1.2bn)/year Health Services and need to deliver Delivery Research good services? Applied health programme research system C£16m (€19.8m) for the Focus on quality and  UK’s NHS effectiveness of  healthcare systems  Therefore we assess research topics for need BEFORE scientific merit
  3. 3. What do we mean by need? Ability to benefit – mediated through service organisation and delivery 3Stevens, A. and Raftery, J. (1994) Health Care Needs Assessment: The Epidemiologically Based Needs Assessment Reviews.Oxford: Radcliffe Medical
  4. 4. Identifying need (the right research questions)Engaging with the research-using community; meeting its needsCollect suggestions for research throughout the year from individuals, patients,public, professionals, literature, societies and groupsAnnual stakeholder engagement exercise involving senior managers, serviceproviders and some academicsFurther selection and prioritisation by a standing panel made up of external (to us)independent NHS managers, clinicians, researchersLiterature and evidence summary written and reviewed by expertsCall for research advertised. Final list of approved topics forms the research agenda forthe HS&DR programme 4
  5. 5. What do we mean by integration? 5
  6. 6. Integrated care portfolio: April 2009 – Sept 2011Specific calls for research relevant to integrated care Call title Funding Evaluating Innovations in Integrating Health £2m (€2.5m) Research on Primary Care and Community care and Community Health Services £3m (€3.7) NHS Care Homes £3m (€3.7) Patient safety in healthcare organisations £2m (€2.5m) Expedited evidence synthesis to support decision-making by managers and leaders in the NHS £50k-80k (~€80k) per projectTotal portfolio (specific calls and open calls) Research type Projects funded 42 Funding £14.5m (€18m) out of £35m committed (€43m) across all calls Mean cost £350k (€430k) Mean duration 31 months Secondary 6 only 9%
  7. 7. Completed research In progress‘Self care and case management in ‘Assessing outcomes of integrated care for people with long termlong term conditions’, Professor David conditions’, Professor Gillian Parker, Uni’ ofChallis, April 2008 York•Map current provision •How health and social care services•integrated care initiatives as have been integrated?determinants for entry to and exit •What outcomes do people with longfrom case management term conditions want?‘Self management support among ‘Analysis of virtual wards’, Dr Geraintolder adults’, Ms Suzanne Parsons, April Lewis, Nuffield Trust2010 •Do Virtual Wards lead to changes in•experiences and expectations use of care? •What are the costs and savings of Virtual Wards? 7 All have project webpages with descriptions, protocol and final reports
  8. 8. Mensajes para llevar a casa(take home messages)• NIHR Health Service and Delivery Programme is focussed on evidence for UK NHS healthcare managers and decision-makers.• We commission research based on the need of the NHS in addition to scientific merit• We have commissioned a significant and balanced portfolio of research relevant to integrated care• All will publish freely available comprehensive final reports on our websiteFurther information hsdrinfo@southampton.ac.uk NIHR stand www.nihr.ac.uk in the www.netscc.ac.uk/hsdr/ exhibition! @officalNIHR - #NIHR Paper submitted to Journal of Integrated Care 8This presentation presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
  9. 9. ADDITIONAL SLIDES 9
  10. 10. Example completed Research‘Self care and case management in ‘Self management support amonglong term conditions’, older adults’, Ms Suzanne Parsons, Picker InstituteProfessor David Challis, University of Europe, April 2010Manchester, April 2008 Look at integrated Investigate the Compare these care self Map current experiences initiatives as management provision of and determinants experiences NHS case expectations for entry to and management against the and exit from expectations services. availability of case of older support management people services 10
  11. 11. Example research under way‘Analysis of virtual wards’, ‘Assessing outcomes of integrated care for people with long term conditions’,Dr Geraint Lewis, Nuffield Trust Professor Gillian Parker, Uni’ of York Do Virtual How health Wards lead and social care Work with to changes Develop an services services to in use of interactive have been introduce the care? cost model integrated? outcomes for optimal required by What are the configuration What people with costs and of Virtual outcomes do long term savings of Wards people with conditions Virtual Wards? long term conditions want? 11
  12. 12. What do we mean by impact? Outputs (e.g. Outcomes papers) (e.g. guidance) Research Need 12 Therefore we assess research topics for need BEFORE scientific merit
  13. 13. Our theory of changeEnvironment level: The research pathway ImpactSystem level: Adding value to research – avoidable waste ImpactBased on Chalmers and Glasziou. Avoidable waste in the production and reporting of research evidence. Lancet (2009) vol. 374 (9683) pp. 86-9 13
  14. 14. Our ‘needs-led approach’Needs-led, science-added evidence production = more important, higher quality, less waste = higher impact Patients, public and the NHS at the heart of the funding process and funded projects 14
  15. 15. The NIHR Health Research System Faculty Investigators & Senior Trainees Associates Investigators UniversitiesInfrastructure Research NHS Trusts Clinical Research Research Projects Networks Patients & Programmes & PublicClinical ResearchFacilities, Centres Research Schools & Units Research Research Governance Information Systems Systems 15 Systems
  16. 16. NETS (Evaluation, Trials and Studies programmes) Systematic Reviews programme Inc. UK Cochrane Centre Cochrane Review Groups Health Services NETSCC: Established: 2008 CRD and Delivery Research Public Health Established 2012 by Research merging HSR and SDO Established: 2008 Health Technology Assessment Efficacy and Mechanism Evaluation Established: 1993 Researcher-led Funded by the MRC Managed by NIHR Commissioned Funded and managed by NIHR Established: 2008 and 2011 16
  17. 17. Research funding contextNational Institute for Health Research•£1bn (€1.2bn)/year applied health research system•UK Department of Health (with contributions from devolved administrations)Health Services and Deliver Research:•One of the NIHR’s funding programmes•Focussed on service delivery, organisation, knowledge transfer, quality, effectivenessand accessibility of the UK NHS•For healthcare managers and decision-makers.Our approach: Adding value to research – reducing avoidable wasteBased on Chalmers and Glasziou. Avoidable waste in the production and reporting of research evidence. Lancet (2009) vol. 374 (9683) pp. 86-9 Impact Ask the right Answer them 17 questions the right way
  18. 18. Who are we – what do we do? What National Institute for research do  managers Health Research need to deliver good £1bn (€1.2bn)/year Health Services and services? Delivery Research Applied health programme research system C£16m (€19.8m) for the Focus on quality and  UK’s NHS effectiveness of  healthcare systems  Impact e.g. better services Ask the right Answer them 18 questions the right way
  19. 19. Self-care and Case Managementin Long-term ConditionsProfessor David Challis, University of Manchester To identify To classify by the extent observable To map and nature features, current of self-care different provision of initiatives initiatives of NHS case and to look integrated managemen at the role of Final report care both t services in these published in between primary care initiatives as April 2008 primary and for people determinants secondary with long- for entry to care, and term and exit from between conditions case health and managemen social care t services 19
  20. 20. Self Management Support amongOlder AdultsMs Suzanne Parsons, Picker Institute Europe To To compare investigate these against the self the managemen In four availability of Final report t geographical support from published in experiences areas of locally based April 2010 and England services and expectations community of older resources people 20
  21. 21. Analysis of Virtual WardsDr Geraint Lewis, Nuffield Trust To develop To assess an To develop the extent to interactive an index for which cost model determining integrating where users To establish the optimal health and input local the costs and case load for social care variables savings of multi- services by and the Virtual Wards disciplinary means of model from the case Virtual advises the perspectives managemen Wards(VW) user as to of society, the t that leads to the optimal NHS and accounts for changes in configuration Local the case- the use of of Virtual Government load versus emergency Wards quality of hospital care locally, care trade- and social taking into off care account case-mix 21
  22. 22. Assessing outcomes of integratedcare for people with long termconditionsProfessor Gillian Parker, University of York To see how services are using the To explore To explore checklist, with people To design a how health whether with long checklist and social services term based on the care change ways conditions, outcomes services of working what required by have been with people outcomes are people with integrated in with long wanted from long term four term integrated conditions geographical conditions, health and for services areas in whether the social care to use England checklist services helps people get what they need 22
  23. 23. Identifying the right research questionsEngaging with the research-using community; meeting its needsAnnual stakeholder engagement exercise•Collect suggestions for research throughout the year•Present to a wide participatory workshop made up of NHS managers, decision-makers, organisation representatives, researchers•Hone down the list of some 50 topics to 20•Further selection by the prioritisation panel made up of NHS managers,clinicians, researchers•Final list of topics forms the research agenda for the HS&DR programme 23
  24. 24. What happens in practice: work streams Types of Who defines Frequency Research the question? Per year Commissioned Primary research HS&DR 3 calls per year Commissioned Evidence synthesis programme (6+ topics) Researcher-led Primary research Researcher 3 calls per year Researcher-led Evidence synthesis 24
  25. 25. Two stage assessment process • Health need • Expressed need • Sustained interest • Capacity to generate new knowledge • Actionable findings and prospects for change Answering them the right way: assessing the Scientific quality and appropriateness •Quality and scientific merit •Links with knowledge users and where appropriate •Value for money •See Tara Lamont presentation… 25

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